ABSTRACT: The prevalence of HIV among prisoners is several-fold greater than found in the general community. Over one quarter of all HIV+ individuals cycle through the U.S. correctional system annually. Correctional facilities are a structured, but important point of contact for high risk HIV+ individuals who return to our communities. To date, there have not been fully comprehensive prison-release programs that are designed to meet the needs of released prisoners and their community. They have primarily been predicated only on various case management models and have not demonstrated continued stability in HIV outcomes after release. Hence, integrated programs have lacked adherence to antiretroviral therapy and reduction in HIV risk taking interventions for HIV+ prisoners transitioning to the community. In this proposal, we seek to integrate two existing programs in Connecticut (Project TLC and Project CONNECT) and layer on a modified HIV risk reduction intervention, adapted from the Holistic Health Recovery Program (HHRP), to be administered within prison and as a booster session three months after release. We intend to modify the HHRP to a four-session intervention within the prison setting during the 90 days prior to release. We will call this the Pre-Release Healthy Transition (PHT). Combining the PHT with the existing Project TLC (transitional case management services for released prisoners) and Project CONNECT (a randomized controlled trial of directly administered antiretroviral therapy versus standard of care for opioid dependent patients who are linked to opiate agonist therapy after release) will result in the comprehensive prison release program now called Project TLC+. The availability of existing resources for Project TLC and Project CONNECT allow for the infrastructure to fully implement a comprehensive transitional program for HIV+ prisoners. Additional strengths of this proposal are the collaborations between a community based organization experienced with prison release programs (AIDS Project Hartford), the HIV in Prisons Program at Yale University, and the Connecticut Departments of Correction and Public Health. The existing resources, the strong collaborations, the experience of the investigators working in community and correctional settings and past track record of these programs markedly influence the likelihood of successfully implementing an effective intervention and completing the proposed research. [unreadable] [unreadable] [unreadable] [unreadable]